2014年 · 第94卷第45期

In the field of preoperative evaluation of epilepsy, there has been a dispute between the so-called "North American School" and the "French School", with different ideas, techniques and methods. For a long time, the preoperative evaluation of epilepsy in China has been taught by the North American school of thought. This paper gives an overview of the academic thoughts of the French School that are rising in the world at present, and discusses its enlightenment to our country, in order to arouse the attention of domestic comrades.

Distal degloving injury of finger is a difficult injury in hand surgery. The principle of microsurgical repair of finger degloving injury is to complete the tissue coverage, reconstruct the sensation of the finger tip and restore the aesthetic appearance of the affected finger to the maximum extent^[1]。 Because of the large area of skin and soft tissue defects and the combined defects on the dorsal side of the palmar, simple abdominal skin flap or free skin flap is used to repair the affected fingers after operation.^[2,3]。 In order to achieve good repair effect, it is often necessary to combine multiple flaps. According to the principle of flap repair in hand surgery, we used adjacent finger flap with dorsal perforator of the intrinsic finger artery as vascular pedicle to repair distal finger degloving injury, and achieved good curative effect.

Polycystic ovary syndrome (PCOS) is a variation characterized by hyperandrogenism, ovulatory disturbances, and polycystic ovaries, also known as Stein – Leventhal syndrome, associated with obesity, insulin resistance, dyslipidemia, accompanied by a high incidence of impaired glucose tolerance, type 2 diabetes, metabolic disorders^[1]Its incidence in adolescent and childbearing age women is higher, about 10%. At present, the main causes of PCOS are abnormal secretion of luteinizing hormone (LH), dysregulation of ovarian 17-α hydroxylase, genetic and environmental factors, etc. The pathogenesis of PCOS is still controversial. Petrikova et al.^[2]It was once thought that the ovary is an organ susceptible to immune attack, which can be manifested as premature ovarian failure (POF) or PCOS, while thyroid disease is also an autoimmune disease, often manifested as hyperthyroidism and hypothyroidism. Whether or not there is commonality and correlation between the two has caused extensive research. Gleicher et al.^[3]In proposed a view that PCOS and POF are two opposite extremes in the ovarian aging process, almost similar to hyperthyroidism and hypothyroidism of the thyroid gland. Recently, scholars generally believe that the thyroid gland is closely related to PCOS, and a lot of research has been done for this. This article focuses on summarizing the recent research progress related to this, mainly including PCOS and Graves disease, PCOS and hypothyroidism, PCOS and subclinical hypothyroidism, PCOS and autoimmune thyroiditis (AIT).

Since the 1950s, anterior cervical decompression and fusion (ACDF) has become the "gold standard" in the treatment of cervical spondylotic myelopathy and nerve root type^[1]。 However, more and more studies have found that ACDF can lead to changes in cervical spine dynamics, decreased cervical spine mobility, and increased incidence of adjacent segment degeneration/disease (ASD)^[2]。 artificial cervical disc arthroplasty (ACDA) has attracted people's attention and developed rapidly because it can preserve the mobility of cervical replacement segments and has the potential to reduce ASD. At present, it has become an important surgical method for treating cervical diseases^[3,4]。 However, with the extensive clinical application of ACDA, its related complications have gradually attracted the attention of scholars. The complications of ACDA and its countermeasures are now described.

Benign prostatic hyperplasia (BPH) is a common and frequently occurring disease in middle-aged and elderly men. The incidence rate is>50% in men over 60 years old and 90% in men over 85 years old^[1]。 BPH easily leads to lower urinary tract obstruction, including dysuria, frequent urination, urgency, increased nocturia, etc., and eventually causes bladder and kidney damage, which has become one of the important diseases affecting the health of middle-aged and elderly men. At present, drugs are the first-line treatment for the treatment of BPH, which is suitable for moderate degree of lower urinary tract obstruction. The most commonly used drugs are α-1 receptor blockers and 5-α reductase inhibitors. These two drugs can be used alone or in combination. Application can reduce the symptoms of obstruction to a certain extent, but the efficacy is limited^[2,3,4]。 Transurethral prostatectomy (TURP) is currently the most commonly used method to treat patients with severe lower urinary tract obstruction caused by BPH and poor drug therapy. It mostly needs to be performed under general anesthesia, and there is a certain proportion of intraoperative bleeding, postoperative urinary incontinence, sexual dysfunction and other complications^[5]。 There are many reports on the clinical application of various minimally invasive techniques, trying to replace traditional surgical treatment and reduce the risk of treatment, but there are still some problems. In the comprehensive evaluation of efficacy, complication rate, economic cost, safety, etc., no minimally invasive treatment technique has been proven to be superior to TURP^[6,7]Because of the limited time to maintain efficacy after treatment with these minimally invasive techniques. Therefore, there is a need to develop new therapeutic techniques.